Early Detection of Oral Cancer in General Practice – 30 Years of Searching

This year of 2020, has, without doubt, been momentous. Readers will all have reasons for remembering this year. My hope was that my cohort of graduates from the class of 1990 would have a fantastic 30-year reunion with all of the usual excesses of meeting up with old friends and reminiscing until the early hours. Qualifying as a dentist back then meant that our Oral Medicine tutors would tell us that there were about 3000 new cases of oral cancer, now more appropriately termed mouth cancer (MC) on the advice of Professor Mike Lewis in the present issue, every year and that, if we turned out to be good, observant dental practitioners, then we would probably spot one squamous cell carcinoma (SCC) in our practising career (Figure 1).

Table 1 shows the rise in numbers of MC since the 1980s. At first sight, there would appear to be an exponential rise in cases; but the devil is in the detail. Back in the 1980s, it was classified as ‘mouth cancer’. The first big jump in figures coincides with a name change to ‘oral cancer’, which began to include the oro-pharynx. Nowadays, it has been incorporated into ‘head and neck cancer’, which also includes the sinuses, salivary glands, nasopharynx, larynx, etc. This may be considered confusing when you want to compare like with like.